Ga-68-PSMA Uptake in Brain Metastasis of Gastric Carcinoma

A 69-year-old man with a known history of gastric and prostate adenocarcinoma was referred to Ga-68-prostate-specific membrane antigen (PSMA) PET/CT for restaging due to biochemical recurrence of prostate cancer. Ga-68-PSMA PET/CT revealed tracer accumulation in the primary prostatic lesion, lymph node, bone metastases, and brain lesion, which was later confirmed on biopsy to be metastasis of gastric carcinoma. This case reminds us of the variable spectrum of Ga-68-PSMA uptake in prostatic and nonprostatic metastatic lesions, the potential pitfalls on PET/CT images in the workup of patients with concomitant malignancies.